Asthma unmasked with tumor necrosis factor-α-blocking drugs

Chest. 2011 Oct;140(4):1068-1071. doi: 10.1378/chest.10-2350.

Abstract

We report five cases of asthma unmasked by anti-tumor necrosis factor (TNF)-α-blocking drugs. Asthma symptoms appeared within an average of 4 months (range 1-24 months) after starting the anti-TNF-α treatment for inflammatory disease. The patients did not appear to be predisposed to asthma except for one patient who had asthma during childhood. Four patients stopped anti-TNF-α-blocking drugs with an improvement of symptoms within 1 to 5 months. In the patient with a history of childhood asthma, respiratory symptoms recurred when another anti-TNF-α therapy was started. Asthma control was achieved with inhaled steroids, allowing anti-TNF-α treatment to continue. The biotherapy was maintained for the fifth patient in association with inhaled steroids. The pathophysiologic mechanisms are unknown but are probably more complex than the T helper 1/T helper 2 imbalance suggested in the literature, and further studies are required.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab
  • Administration, Inhalation
  • Adult
  • Aged
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Asthma / chemically induced*
  • Asthma / diagnosis
  • Asthma / drug therapy
  • Female
  • Humans
  • Infliximab
  • Male
  • Middle Aged
  • Rheumatic Diseases / drug therapy
  • Steroids / administration & dosage
  • Steroids / therapeutic use
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Steroids
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Adalimumab